| NPI | 1336671189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0071305) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2021-01348) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 62616) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-10-25 |